Research Paper| Volume 35, ISSUE 3, P400-412, July 2022

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(Re-)Defining ergonomics in hand therapy: Applications for the management of upper extremity osteoarthritis


      • Ergonomics includes support for physical, cognitive, and organizational factors
      • Hand therapy ergonomic approaches can be applied at micro, meso, and macro levels
      • There is a dearth of evidence for use of ergonomics in upper extremity osteoarthritis
      • Contextualized and lifestyle approaches best support carryover in daily life
      • Promoting self-efficacy is a vital component for long-term effects of ergonomics


      Study Design

      Invited literature review


      Arthritis is the leading cause of disability in adults, and research shows that people living with arthritis experience work instability, loss of independence, financial difficulties, and overall decreased quality of life. Current nonpharmacological treatments can be beneficial for short term relief; however, the evidence on these long-term treatments is limited. Ergonomic modifications have been used in the workplace to address musculoskeletal conditions to ensure proper fit of one's environment, and research shows that these modifications can decrease pain and injury and increase work productivity. A broader perspective on ergonomic approaches may be important to supporting individuals with arthritis within hand therapy.

      Purpose of the Study

      This review proposes an expanded perspective on ergonomic approaches within hand therapy and explores published literature to identify potential benefits of applying ergonomic approaches for individuals with upper extremity arthritis.


      A systematic search and screening process was conducted to identify articles that implemented an ergonomic approach for the support of individuals with upper extremity osteoarthritis or rheumatoid arthritis.


      A total of 34 articles described interventions that employed ergonomics including task-based or general ergonomics (n = 17), contextualized supports (n = 8), or holistic, lifestyle approaches (n = 9). Only one study focused solely on individuals with osteoarthritis, whereas interventions for individuals with rheumatoid arthritis showed positive outcomes across these categories. Situational learning, building of patient self-efficacy, and development of new habits and routines are vital for carryover and implementation to support performance in daily life.


      There is an opportunity for hand therapists to extend the scope of interventions provided as part of an ergonomic approach to supporting patients. Specifically, therapists can consider use of emerging technologies and telehealth that promote contextualization and follow-up for long-term outcomes.


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      JHT Read for Credit

      Quiz: # 865

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • # 1.
        The study design is
        • a.
        • b.
          literature review
        • c.
          case series
        • d.
      • # 2.
        How many articles specifically addressed ergonomic factors with OA of the upper extremity
        • a.
        • b.
        • c.
        • d.
      • # 3.
        Nora confesses that she
        • a.
          hates her job and her boss
        • b.
          frequently overdoses on her NSAIDs
        • c.
          has difficulty remembering the joint protection ideas she was taught in therapy
        • d.
          didn't relate well to her hand therapist and consequently has been noncompliant to her home program
      • # 4.
        The authors are advocates for
        • a.
          soft tissue massage
        • b.
          telehealth sessions
        • c.
          early surgical intervention
        • d.
          daily meditation
      • # 5.
        The authors suggest that often hand therapists are not utilizing all the ergonomic considerations available to them in case management
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.